Clinical value of two-dimensional echocardiography combined with three-dimensional speckle tracking imaging in predicting major adverse cardiovascular events after percutaneous coronary intervention in acute myocardial infarction
Objective To investigate the clinical value of two-dimensional echocardiography combined with three-dimensional speckle tracking imaging(3D-STI)in predicting major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 98 patients with AMI admitted to our hospital were selected.All patients underwent two-dimensional echocardiography and 3D-STI examination within 24 h after PCI,the left ventricular end-systolic diameter(LVESd),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),rotation angle,torsion angle,global longitudinal strain(GLS),global area strain(GAS),global circumferential strain(GCS)and global radial strain(GRS)were obtained.According to the occurrence of MACE within 3 months after PCI,the patients were divided into MACE group(23 cases)and non-MACE group(75 cases).The differences of the above parameters between the two groups were compared.The correlation between each parameter and the MACE was analyzed,and the importance of MACE warning factors was ranked.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of each parameter on the occurrence of MACE.Results The LVEF,rotation angle,torsion angle,GLS,GAS,GCS and GRS in the MACE group were lower than those in the non-MACE group,and the differences were statistically significant(all P<0.05).There were no significant difference in LVESd,LVEDd,LVESV and LVEDV between the two groups.Correlation analysis showed that LVEF,rotation angle,torsion angle,GLS,GAS,GCS and GRS were negatively correlated with MACE(all P<0.001).The importance of MACE warning factors was ranked as follows:GLS,GRS,GAS,GCS,rotation angle,torsion angle and LVEF.ROC curve analysis showed that the area under the curve for predicting MACE occurrence of combined LVEF,rotation angle,torsion angle,GLS,GAS,GCS and GRS was 0.914,which was higher than the predictive value of each parameter used alone(all P<0.05).Conclusion Two-dimensional echocardiography combined with 3D-STI has certain clinical value in predicting MACE occurrence after PCI in patients with AMI,which can provide an important basis for early assessment of cardiac function impairment after PCI.
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